Necrotic tooth: causes and treatments

A tooth attacked by bacteria requires the intervention of the dentist, because it cannot be healed naturally. If you let the infection progress, the tooth will necrose.

The different stages of a necrotic tooth

The bacteria that live in your mouth start by attacking the surface of your tooth: the enamel. This is how tooth decay is created. If you don't have it treated by a dentist, the bacteria continue to grow and reach the dentin.

At this stage, you are bound to feel pain and you need to go to the dentist urgently, otherwise the infection spreads to the heart of your tooth: the pulp. It is the living part of the tooth. If it is affected, the suffering becomes intense, because it is innervated and vascularized.

When the pulp tissue is attacked by bacteria, it eventually dies. This is called necrotic tooth.

The infection can also spread from the root of the tooth, in which case it is not visible, but just as painful. The germs then pass through the top of the root of the tooth, which is called the apex.

Other causes of dental necrosis

In addition to caries and root passage, dental necrosis can be induced by repeated trauma that alters the health of the dental pulp and precipitates its degeneration. A shock can damage the vascularization of the tooth which is then badly irrigated and becomes fragile.

It can be caused by accidental shocks, by playing a sport like boxing, or by a behavioral defect, such as bruxism, which consists of grinding one's teeth by rubbing the two jaws together. Surgery performed close to the pulp can also cause significant trauma (e.g., placement of a post or a crown).

Wherever the infection comes from, the risk is that the bacteria will progress to the jawbone and cause increasingly serious consequences. It can start with an abscess and develop into periodontal disease, with loosening and then falling out of the teeth.

In all cases, the necrosis of the tooth is irreversible.

What are the signs of a necrotic tooth?

Before a tooth necroses, you inevitably go through intense pain that can be stabbing and continuous, punctuated by spikes – the famous toothache – that are very difficult to bear.

If you have not visited your dentist, the pain stops when the tooth is dead. However, the danger remains, as the infection can spread to adjacent teeth, as well as to the jawbone.

Once the tooth is dead, it changes its color to grayish shades. They are caused by the degeneration of the hemoglobin in the blood cells, similar to a hematoma that leaves yellow, green and brown marks.

How to treat a necrotic tooth?

The death of the tooth does not mean that you are exempt from visiting the dentist. It is essential that the infection be contained to prevent it from spreading to the rest of the mouth.

The tooth must be devitalized. This consists of removing the nerve and the necrotic pulp, then eradicating the bacteria. The cavity is carefully disinfected and then resealed to make it watertight so that it can no longer serve as a refuge for bacteria.

This operation weakens the tooth, because of the loss of tissue. In particular, it can become brittle and require a crown. The advantage of the crown is that it can be made of ceramic, in a shade identical to that of your natural teeth.

If it is a back tooth, you can have a less expensive and better reimbursed metal-colored crown. The metal crown is a little less expensive, but less aesthetic. The crowns installed today last more than 20 years, so it may be worth spending a little more money on them.

Health insurance coverage for necrotic teeth

Ask your dentist for an estimate, as rates differ from one practitioner to another. The health insurance reimburses 70% of the conventional rates, which are as follows

• devitalization of an incisor or canine : 33,74 € ;
• devitalisation of a premolar : 48,20 € ;
• devitalization of a molar : 81,94 €.

The installation of the crown is reimbursed at 75.25 €, while it costs on average 600 €. Send your dentist's estimate to your mutual insurance company to find out what you will have to pay.

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